Phase II Trial of Syncopated Thalidomide, Lenalidomide, and Weekly Dexamethasone in Patients With Newly Diagnosed Multiple Myeloma

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• 作者：Madiha Tufail ; David S. Siegel ; Laura McBride ; Elizabeth Bilotti ; Erica Bello ; Palka Anand ; Karly Olivo ; Urszula Bendarz ; Ann McNeill ; David H. Vesole ; ^{dvesole@humed.com}
• 关键词：Immunomodulatory agents ; Induction therapy ; Myeloma
• 刊名：Clinical Lymphoma Myeloma and Leukemia
• 出版年：2012
• 期刊代码：pca95_21522650
• 类别：med
• 出版时间：June, 2012
• 卷：12
• 期：3
• 页码：186-190
• 文件大小：234 K

摘要

Introduction

Over the past decade, the novel agents thalidomide, lenalidomide, and bortezomib have emerged as effective treatment in patients with multiple myeloma (MM). Initially used in the relapse setting, these agents have been incorporated into frontline treatment algorithms. They have been combined in doublets with corticosteroids, in triplets with alkylators, or with each other. Because thalidomide and lenalidomide have different clinical activity and toxicity profiles, we designed a trial to evaluate a syncopated schedule of thalidomide and lenalidomide with weekly dexamethasone in patients with newly diagnosed MM to determine response and toxicity.

Patients and Methods

Twenty-two patients with newly diagnosed MM were treated with syncopated thalidomide (200 mg on days 1-7 and 15-21), lenalidomide (25 mg on days 8-14 and 22-28 for the first cycle and 50 mg on the same schedule for subsequent cycles) with weekly dexamethasone (40 mg). Each cycle lasted 28 days. MM parameters were assessed at the end of each cycle. It was intended that the patients proceed to stem cell mobilization and autologous transplantation after 4 cycles of therapy.

Results

The median number of cycles administered was 3.5. The overall response was 68%. The regimen was well tolerated by the majority of the patients; only patient discontinued treatment because of toxicity.

Conclusion

We conclude that a syncopated schedule of thalidomide and lenalidomide with weekly dexamethasone was tolerated well, with no unexpected toxicities. However the response rate, even using lenalidomide at 50 mg, was not superior to standard dosing of thalidomide or lenalidomide plus dexamethasone.